Term
What is the job of the receptionist every morning?
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Definition
Arrive at least 30 minutes prior to the first appointment, retrieve the messages and prepare the charges and office
Unlock appropriate doors, disengage alarm system, turn on appropriate lights, turn on computers, printers, copiers, and other electronic devices and check for specimens that may have been forgotten |
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Term
Where should the receptionist check for messages at the begining of each day?
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Definition
| Answering service, voicemail systems, electronic mail, facsimile machines |
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Term
| How should patents be greeted by the receptionist? |
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Definition
| Make every attempt to greet patients personally, register and orient patients, make sure new patients complete a registration form called a patient information sheet, then orient the patient to the offive and manage the wait time by notifiying the patient when they'll be seen |
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Term
Who can you demonstrate the professional image to a patient?
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Definition
Professional image consist of good attitude, being a good role model, and using courtesy and diplomacy in the office
Attitude- is a state of mind of feeling regarding some matter
Role Model- includes good health, good grooming, positive image and follow the dress code
Diplomacy- is the art of handling people with tact and genuine concern |
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Term
| What are the 5 basic guidelines for telephone use? |
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Definition
1. Dictation- refers to how words are spoken and enunciated
2. Pronunciation
3. Expression
4. Listening
5. Coutesy |
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Term
| What do you write in the appointment book? |
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Definition
| Patient information such as name, telephone number and reason for visit, make sure there is matrix for each doctor and block out time that is not avalible and if manual makeu sure there is enough space for information in appointment book |
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Term
What do you do when you schedule a new patient?
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Definition
1. Allow an adequate amount of time for the appointment
2. Explain the office's payment policy
3. Be sure the patient knows where the office location is and give direction if needed
4. Some patients are sensitive about messages get safe place to call and leave messages
5. Before ending the call confirm the time and date of appointment
6. Always check the appointment book to make sure information is correct
7. If the patient is referred by another physican may need to call referred office ahead a time to get lab work
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Term
Why would you prefer to enter claims electronically?
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Definition
| Claims can be filed immediately reducing the time for the reimbursement cycle; several regional and national clearninghouses recieve health benefits claims end electronically directi them to the appopriate claims adminstrator which alls you to gile claims through one clearinghouse rather than filing sepratly though each claims adminstrator allows for less errors and faster reimbursement times |
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Term
What are the different types of reminder systems?
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Definition
Appointment cards
telephone reminders
Mailed cards |
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Term
| When answering the phone what is your first responsiblity when handling an office emergency? |
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Definition
The first responsibilty is to determine whether the problem can be treated in the office reter to STAT ask specific questions to determine if they need to be seen immediately or go to the emergancy room
STAT-Immediately |
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Term
| What can happen if you write an inaccurate business letter? |
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Definition
| Inaccurate information in some letters can lead to injury of the patient and lawsuites and can harm the physicians practice |
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Term
| What are the 3 letter formats? |
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Definition
1. Full Block- each line is flush left; is the most formal and is most commonly used for professional letters
2. Block- the date, subject line, closing, and signatures are flush right and all other lines are flush left
3. Semiblock- the first sentence of each paragraph is indented 5 spaces; also referred to as modified block
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Term
Who does Medicare cover and how are they enrolled?
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Definition
| Medicare provides coverage to the elderly defined as a person age 65 or older and persons who have been recieving social security benefits for 24 months and person suffering from end-stage-renal diseasel people recieving social security benefits are automatically enrolled in medicare part A and part B the can opt-out for part B |
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Term
| What is the difference between part A and part B? |
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Definition
Part A- covers hospital expenses and is provided at no additional charge to persons eligible for social security benefits
Part B- pays for phyician fees, both inpatient and out patient, diagnosic testing, certain immunizations, and specific screening test and is optional there is a fee which is deducted from the monthly social security payment |
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Term
| What form do you use to submit a insurance claim? |
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Definition
| Health Insurance Claim Form |
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Term
| What is listed in Box 1 of the health insurance claim form? |
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Definition
Box 1 is where the vlaim is being submitted; confirm the patient's coverage and accuracy of your file information a change in the paitents coverage will change hou the claim is filed
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Term
Why would you audit a chart?
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Definition
| Helps improve the quality of care, accurate billing, detecting fraud, and allows errors to be found before and actual chart audit and accurate care |
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Term
| What is TRICARE and who does it cover? |
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Definition
| New name is CHAMPUS is admistered by the US Dept of Defense and provides medical coverage to dependants of active service, dependants of service personnel who have died during active service and retired service personnel |
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Term
| What are DRG's and what are they used for? |
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Definition
DRG- Diagnostic Related Group are categories into which inpatients are placed according to the similarity of their diagnoses, treatment and lengh of hospital stay used primarly for reimbursement for Medicare patients
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Term
| What are the 4 key elements of a managed care program? |
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Definition
1. Precertification of hospital admissions
2. Approved referrals
3. Network
4. Assignment of benefits
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Term
| What are the 3 volumes of the ICD-9 book? |
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Definition
Volume 1- contains the classification of diseases (conditions) and injuries by code numbers, grouping of disease and injuries by etiology or cause and anatomic system each chapter had heading or title and follow the 3 diget categories
Volume 2- Alphabetic Index to disease contain diagnostic terms that do not appear in volume 1 and is divided into 3 sections
-Section 1 Alphabetic index to disease and injuries is organized by main terms printed in bold face type and used for reporting the reason for the patient encounters for most insurances
-Section 2 Table of Drugs and Chemicals
-Section 3 Alphabetic Index to external causes
Volume 3- Tabular List and Alphabetic Index of Procedures is used for inpatient facilities and is based on anatomy not surgical specialty |
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Term
| Who has to approve the changes to the ICD-9 codes? |
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Definition
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Term
| What is the HIPPA security rule intended to prevent? |
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Definition
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Term
| How does a debit adjustment affect a patients account? |
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Definition
| A debit adjustment adds to the patients account balance which affects the balance on the account |
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Term
What is the most common bookkeeping system? |
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Definition
Most medical pratices use the single-entry bookeeping system |
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Term
How does insurance capitation work?
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Definition
Capitation- managed care plan that pays a certain amount to a provider over a specific time for caring for the patients in the plan regardless of who or how many services are preformed
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Term
| What is professional courtesy? |
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Definition
| Are an adjustment in which other health care professionals are charged a reduced rate and a physician may choose not to charge a fee at all |
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Definition
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Definition
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Definition
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Term
| What are the things you should not do when answering the phone? |
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Definition
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Term
| What are the 3 mechanics of a letter? |
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Definition
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